Intervention Strategies

 

e considered the scenario of an epidemic in a school and tested the effect of different reactive interventions among the students. More specifically, we have simulated the dynamics of epidemic spread among school children by using an SEIR model on top of a high-resolution time-resolved contact network measured in a real primary school. The model included asymptomatic individuals and a generic risk of infection due to random contacts with the community when children are not at school. Using this model we have studied the targeted strategies for class and grade closure both in terms of their ability to mitigate the epidemic and in terms of their impact on the schooling system (and therefore indirectly on the whole community), measured by the number of cancelled days of class. Targeted strategies are implemented as reactive contact removals, i.e. the contact network of the students is modified according to certain rules that depend on the infectivity profile of each individual. We found that All targeted strategies lead to an important reduction in the probability of an outbreak reaching a large fraction of the school population. In the case of large outbreaks, targeted strategies significantly reduce the median number of individuals affected by the epidemic. The reduction is stronger if the strategies are triggered by a smaller number of symptomatic cases, and if longer closures durations are used. While the closure of one class yields a smaller mitigation effect than the closure of the whole school, the closure of the corresponding grade (two classes) leads to a reduction of large outbreak probability and a reduction of epidemic size that are similar to those obtained by closing the entire school. Remarkably, the reactive character of all strategies we studied, which are triggered by the detection of symptomatic individuals, limits the impact on the schooling system with respect to a closure of schools scheduled in a top-down fashion by public health authorities: the latter would be enforced even for schools that are free of infectious individuals. Second, targeted grade closure has in all cases a much lighter burden, in terms of lost class days, than whole-school closure. Given also its good performance in the mitigation of outbreaks, it thus represents an interesting alternative strategy to traditional approaches that are based on a simplified description of the epidemic process. 

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